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https://doi.org/10.14300/mnnc.2024.19003

Comparative influence of non-selective β-blockers and the combination of endoscopic ligation of esophageal varicose veins with non-selective β-blockers on secondary prevention of bleeding in patients with ascites included on the waiting list for the liver transplantation

[Internal diseases]
Roman Vyacheslavovich Korobka; Sergey Vladimirovich Gautier; Viktor Dmitrievich Pasechnikov; Ekaterina S. Pak; Alexander Mikhailovich Shapovalov; Dmitry Viktorovich Pasechnikov; Ivan Anatolyevich Porshennikov;

We conducted a retrospective comparative study of the effectiveness of a non-selective β-blockers combination and endoscopic ligation of varicose veins with monotherapy of non-selective β-blockers for secondary prevention of esophageal bleeding in patients with non-refractory (n=232) and diuretic-refractory ascites (n=334) included in the waiting list for the liver transplantation. There were no significant differences between the groups in clinical, laboratory, demographic parameters, MELD scores and Child-Turcotte-Pugh cirrhosis classes, or the frequencies of medium and large varices. The effectiveness of secondary prevention of bleeding is higher when using a combination of non-selective β-blockers and endoscopic ligation of varicose veins than monotherapy with non-selective β-blockers for both forms of ascites. When using a combination of non-selective β-blockers and endoscopic ligation of varices, the proportion of patients without bleeding is significantly higher in the group of patients with non-resistant ascites than with ascites refractory to diuretic therapy.

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Keywords: waiting list for liver transplantation, ascites, bleeding, non-selective β-blockers, endoscopic ligation of varices, secondary prevention of bleeding